AccountId: 011433970860
ContactId: 43abb202-157b-4013-8a1e-8315c5e90c21
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 487160 ms
Total Talk Time (AGENT): 205562 ms
Total Talk Time (CUSTOMER): 203290 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/43abb202-157b-4013-8a1e-8315c5e90c21_20250410T19:58_UTC.wav
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[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, I'm trying to find out about my about a client.
[AGENT][NEUTRAL] OK, could I get your name and a callback number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII]. What is it? [PII], excuse me, [PII].
[AGENT][NEUTRAL] Thank you. And the policy number you're calling on today?
[CUSTOMER][NEUTRAL] Um, 258-300-02.
[AGENT][NEUTRAL] OK, if you could verify your date of birth, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, thank you so much for verifying your account and you said you're calling in reference to a claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and this is a disability claim?
[CUSTOMER][NEUTRAL] Short time.
[AGENT][NEUTRAL] Short term disability. OK, hold one moment.
[AGENT][NEUTRAL] OK. Uh, now I do show, um,
[AGENT][NEUTRAL] Let's see, the most recent, well, um, [PII], it looks like, um, medical records have been requested from Doctor [PII].
[CUSTOMER][NEUTRAL] your
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] OK. I'm trying to find out exactly.
[CUSTOMER][NEUTRAL] Cause it was saying something about it the clause in there that you have to be treated or something about the, the treatment within a year of the policy or whatever. But, OK, um.
[CUSTOMER][NEUTRAL] The, the thing is.
[CUSTOMER][NEUTRAL] I went to a regular for a regular eye appointment, December, I guess it was in December, last part of December. Um, they referred me, she told me the, the eye doctor told me I had cataract.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] referred me to the surgeon that just did my cataract surgery. And um I guess I saw him, I guess that was the date I saw him [PII], the end of last year, I believe. I guess that's, that's when I saw him. OK. So, he told me that I needed the surgery, but I'm a truck driver. I can't, I couldn't just, and I run teams.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I couldn't just take off just like that. I had to wait and get, you know, until I could get somebody to replace me in order for me to take off to get the surgery done. That's why it took so long cause they was trying to say, you know, that I waited too long or that I waited, you know, that there was a big gap in between when they told me and when I got the surgery. But that's why, because of that. So I, I'm like now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, they're saying that they might not want to pay me and I'm like, he didn't do treatment. All he did was, was, um, what do you call that consultation that day, that, that was it.
[AGENT][NEUTRAL] Like, OK, yeah. Mhm.
[AGENT][NEUTRAL] OK, so let me get you over to the disability department, um,
[CUSTOMER][NEUTRAL] So basically,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] They will be better, um.
[AGENT][NEUTRAL] Able to explain or to take your explanation, uh, that is a different department, so I'm not really sure um those time frames or limitations with the policy, but let me get you over to a representative that can help you.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold one moment.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi, [PII], um.
[AGENT][NEUTRAL] I'm trying to get to the disability department. uh.
[AGENT][NEUTRAL] Is this the disability department?
[CUSTOMER][NEUTRAL] Mm this is the care team um we're the first point of contact before we we go to other departments. How can I, yes ma'am, um, can I please.
[AGENT][NEUTRAL] OK, I thought so.
[AGENT][NEUTRAL] Send over. OK.
[AGENT][NEUTRAL] So, um, I have an insured on the line. The, let me give you the policy number, 258.
[CUSTOMER][NEUTRAL] Mhm. Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] 3002.
[CUSTOMER][NEUTRAL] OK, and what is your name please?
[AGENT][NEUTRAL] This is [PII] in claims.
[AGENT][NEUTRAL] I'm in the claims department.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, OK, uh, you sounded like a provider there for a minute and I was like wasn't really sure.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] OK. So, [PII], um, now,
[CUSTOMER][NEUTRAL] We click on claims support when we need to transfer to claims. It doesn't have the individual um queues anymore.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So you would need to go um you can get off of me and then do your drop down and click on claim support.
[AGENT][NEUTRAL] OK, hold on, let's see.
[AGENT][NEUTRAL] Claim support.
[AGENT][NEUTRAL] And that's gonna go, who am I gonna get? Is it gonna be disability claims or is that gonna come?
[CUSTOMER][NEUTRAL] You're gonna
[CUSTOMER][NEUTRAL] Well,
[AGENT][NEUTRAL] Because I'm in medical. I'm in Medlink.
[CUSTOMER][NEUTRAL] Whoever is
[CUSTOMER][NEUTRAL] Right, right, whoever answers that has been trained with all the different um.
[AGENT][NEUTRAL] Oh got it OK.
[CUSTOMER][NEUTRAL] Types of insurance that we have.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, did they go with this? Did I miss something? Yeah, I mean, when did they, did they tell us? I'm gonna have to check with [PII] like, I, I'm like, I'm always like, did I not get the memo? What happened? OK, so claim support is what I'm looking for.
[CUSTOMER][POSITIVE] Yeah, they're making big changes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. OK. I'll do that.
[CUSTOMER][NEUTRAL] And that uh and anybody there should be able to help you with your disability claim.
[AGENT][NEUTRAL] Oh OK.
[AGENT][POSITIVE] OK, thank you, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] You're welcome, Ms. [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], what are you doing answering the phone? It's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Honey, this is what they have us doing, [PII].
[AGENT][NEUTRAL] Are you for real?
[CUSTOMER][NEUTRAL] In addition to everything else.
[AGENT][NEUTRAL] OK. OK. Well, I got an insured on the phone. It's, it's a disability claim. So I told her what's going on with her claim. So now she's wanting to explain and at this point, I'm like, I don't, I thought she needs to speak with somebody on disability, but the policy is 258.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 3002.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so I told her the claim that was, we requested the medical records from Doctor [PII].
[AGENT][NEUTRAL] Um, so she's saying, she's starting to explain. I, I guess it has something to do with her policy and at the time, something about the time limit from when she sees a doctor to the actual surgery. So I, I'm guessing she's thinking her claims about to be denied. So now she's trying to explain.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Like her whole doctor, like when she went to the doctor, why it was only for a consultation.
[AGENT][NEUTRAL] Uh, so, yeah, when she got into that, I wasn't really sure. I thought she needs to speak with the clients examiner.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you can send her on over.
[AGENT][POSITIVE] Alright, thank you, [PII], here she comes.